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Munroe, Ocala Regional could lose over $4 million in Medicaid funding

Tallahassee, FL - March 2, 2012

Published in the Star-Banner on Friday, March 2, 2012 at 5:18 p.m.

Medicaid funding for Florida hospitals will be cut about 7 percent — a total of about $376 million — under a tentative agreement reached in budget talks by state lawmakers.

The cut — including a limit on emergency room visits — brings total reductions to the hospitals to 19.5 percent over the past two years, totaling some $871 million. Under the deal, Munroe Regional would lose $3.2 million, while Ocala Regional would lose $1 million, officials said.

Although the hospitals have avoided the deeper cuts originally advanced by Gov. Rick Scott and the Senate, their advocates say the cumulative cuts will hurt the facilities that treat some of Florida's poorest and sickest residents.

Meanwhile, counties could also be forced to pay millions of dollars for Medicaid costs under a proposal that is still being discussed.

According to the Florida Association of Counties, under the Senate plan, Marion County's cost would rise from $2.7 million to $5.7 million in the coming year.

"We're not real happy," said Tony Carvalho, head of the Safety Net Hospital Alliance of Florida. "We're talking about nearly a 20 percent reduction in a two-year period, all below cost."

The cuts mean the loss of hundreds of millions of dollars in federal matching funds, Carvalo added.

"It's cost shifting this un-reimbursed cost back to our communities," he said. "We understand the challenge that they have, but we believe 7 percent is too high."

The 7 percent cut is substantially less than the $1.9 billion cut sought by Scott before the 2012 legislative session started and is less than the roughly 10 percent reduction that had been advanced by the Senate.

Sen. Joe Negron, R-Stuart, who oversees health and human services spending in the Senate, said the agreement represents a compromise that also reflects the Senate's effort to limit cuts to nursing homes. As part of the offer, the Senate has agreed to 1.25 percent Medicaid rate cut for nursing homes to replace the 2.5 percent cut advocated by the House.

"We've done the best we could with the resources that we have to properly fund our hospitals," Negron said, noting children's hospitals and rural hospitals will not be cut. "We've had to balance a lot of competing needs."

The final cuts may be slightly less for individual hospitals since the figures include a limit of six emergency room visits per year for Medicaid patients. Lawmakers appear headed for a compromise on a nine-visit limit.`

Meanwhile, county governments are raising the alarm about a Senate plan — which is part of the final budget negotiations — that could impose a $150 million cost on the counties, representing a dispute between the state and local governments over how Medicaid costs are billed. The House has yet to agree to the plan.

Negron said many of the counties have been delinquent in paying their share of Medicaid costs and the Senate has a plan for the counties to reimburse those costs over the next three years, with a 15 percent discount.

But Cragin Mosteller of the Florida Association of Counties said the local governments believe the billing system is flawed and are trying to work out a settlement with Scott's administration. She said the counties oppose the Legislature's effort to try to settle the matter by passing a new legislation.

"The billing system is broken," Mosteller said. "It needs to be fixed. It doesn't need to be made law."


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